背景:许多有丈夫或伴侣的已婚育龄妇女在使用避孕药具方面不太合作,经常导致意外怀孕或秘密使用避孕药具。这种私人使用避孕药具导致妇女在没有适当支持的情况下遭受副作用,埃塞俄比亚的许多妇女死于意外怀孕。然而,在埃塞俄比亚,丈夫或伴侣参与避孕决策过程往往被忽视。在埃塞俄比亚,也缺乏关于丈夫或伴侣决定使用避孕药具的决定因素的证据。
目的:本研究旨在评估埃塞俄比亚妇女避孕决策过程中丈夫/伴侣参与程度低的决定因素。
方法:本研究基于埃塞俄比亚人口和健康调查数据,2016年1月18日至6月27日收集。纳入了3,669名育龄女性的加权样本。丈夫/伴侣的独立决策是通过丈夫/伴侣独立还是单独决定避孕药具的使用来衡量的,分类为“是”或“否”。拟合了多水平Logistic回归模型,和ICC(类内相关系数),MOR(中值赔率),PCV(差异比例变化),和偏差用于评估模型适合度和比较。双变量分析中p值≤0.2的变量被认为是多变量多水平分析的候选变量。使用具有95%置信区间的调整后的优势比来确定关联的方向和强度,p值<0.05表示有统计学意义。
结果:发现丈夫/伴侣在妇女避孕药具使用中的独立决策为5.41%[4.72-6.19%]。与此相关的重要因素包括:31-59岁的丈夫/伴侣(调整后的赔率比(AOR)=1.3;置信区间(CI)2.3-5.4)和59岁以上(AOR=2.3;CI1.2-4.3),丈夫/伴侣的教育水平:初等教育(AOR=3.2;CI2.9-4.3),中等教育(AOR=3.9;CI2.7-4.4),和高等教育(AOR=4.3;CI2.8-5.0),媒体曝光(AOR=4.5;CI2.2-5.4),终止妊娠史(AOR=3.3;CI2.6-4.1),认识到距离医疗机构不是一个重大问题(AOR=3.0;CI1.7-4.7)和城市居住权(AOR=3.5;CI1.6-4.2)。
结论:在埃塞俄比亚,丈夫/伴侣参与避孕药具使用决策过程的比例较低.为了提高他们的决策权,应注意年龄等因素,教育水平,媒体曝光,终止妊娠史,距离卫生设施,城市居住权。
BACKGROUND: Many married women of reproductive age with husbands or partners are less cooperative in using contraceptives, often resulting in unintended pregnancies or secret contraceptive use. This private use of contraceptives causes women to suffer from side effects without proper support, and many women in Ethiopia die due to unintended pregnancies. However, the involvement of husbands or partners in the contraceptive
decision-making process in Ethiopia is often neglected. There is also a lack of evidence regarding the determinants of husbands\' or partners\'
decision-making power on contraceptive use in Ethiopia.
OBJECTIVE: This study aimed to assess the determinants of low involvement of husbands/partners in women\'s contraceptive use decision-making processes in Ethiopia.
METHODS: This study was based on Ethiopian Demographic and Health Survey data, collected from January 18 to June 27, 2016. Weighted samples of 3,669 reproductive-age women were included. Husbands\'/partners\' independent
decision-making was measured by whether the husband/partner decided independently or alone about contraceptive use, categorized as \"Yes\" or \"No\". A multilevel logistic regression model was fitted, and ICC (Intra-class Correlation Coefficient), MOR (Median Odds Ratio), PCV (Proportion Change in Variance), and deviance were used to assess model fitness and comparison. Variables with a p-value of ≤ 0.2 in the bivariate analysis were considered candidates for multivariable multilevel analysis. An adjusted odds ratio with a 95% confidence interval was used to determine both the direction and strength of the association, and a p-value of < 0.05 was used to declare statistical significance.
RESULTS: Husbands\'/partners\' independent
decision-making in women\'s contraceptive use was found to be 5.41% [4.72-6.19%]. Significant factors associated with this included: Husbands/partners aged 31-59 years (Adjusted Odds Ratio (AOR) = 1.3; Confidence Interval (CI) 2.3-5.4) and over 59 years (AOR = 2.3; CI 1.2-4.3), Educational level of husbands/partners: primary education (AOR = 3.2; CI 2.9-4.3), secondary education (AOR = 3.9; CI 2.7-4.4), and higher education (AOR = 4.3; CI 2.8-5.0), Media exposure (AOR = 4.5; CI 2.2-5.4), History of pregnancy termination (AOR = 3.3; CI 2.6-4.1), Perception that distance to health facilities is not a significant problem (AOR = 3.0; CI 1.7-4.7) and Urban residency (AOR = 3.5; CI 1.6-4.2).
CONCLUSIONS: In Ethiopia, the involvement of husbands/partners in the contraceptive use decision-making process is low. To increase their
decision-making power, attention should be given to factors such as age, educational level, media exposure, history of pregnancy termination, distance to health facilities, and urban residency.